Clitoridectomy: A Nineteenth Century Answer to Masturbation
~ by John Duffy

In the early 19th century perceptive physicians were becoming increasingly
dubious of the traditional medical theories and began turning to clinical
experience. Unfortunately, lacking an understanding of physiology and
with no knowledge of bacteriology, they were frustrated in their attempts
to prevent or cure disease. In desperation, physicians intensified their
use of the traditional therapeutics--bleeding, blistering, vomiting,
purging and sweating, heroic therapy which only served to increase public
suspicion of the profession. Seeking to compensate for their inability
to deal with disease, physicians increasingly began assuming the role
of moral leaders. In the process they seized upon issues such as abortion
and masturbation.

The prudishness of Victorians and veil of silence they cast over sexuality
is well known, but what is not so well known is their preoccupation
with masturbation. Little attention had been given to masturbation until
late in the 18th century, and it was not until the second half of the
19th century that the subject became one of general concern. It first
came to public attention through the efforts of a few moralists, but
it was not until the medical profession, seeking to bolster its status
in society, transformed the moral question of masturbation into a medical
condition that it became a significant issue.

In the case of males, the apprehensions about masturbation were engendered
by a widespread assumption that the loss of semen endangered the brain
and nervous system. In America the superintendent of the Massachusetts
Lunatic Asylum gave credence to this belief when in his 1848 annual
report he asserted that 32 per cent of admissions were for "self-pollution",
one of several euphemisms for masturbation. Reflecting in part the Victorian
preoccupation with sexuality, by the late 19th century medical journals
in Europe and America were attributing almost every conceivable medical
condition to this "secret vice."

Since loss of semen was considered a real danger to males, then it
followed that nocturnal emissions were equally hazardous. To solve both
of these problems, a whole array of mechanical devices were constructed.
They included such items as strait jackets, genital cages, and penis
rings with sharp points on the inside. Most of these objects were devised
by laymen, but the medical profession, which has generally reflected
prevailing beliefs, was not to be outdone. Young men driven by guilt
who sought a physician’s help, or who confessed to masturbation under
close questioning by their physician, were treated with blistering agents,
mild acid solutions, or leeches applied to the genitals. Bloodletting
and cutting the foreskin were also used in serious cases. In at least
one extreme case, at the request of a desperate patient who feared for
his sanity, his physician castrated him. The physician in his report
of the case declared that the patient was gaining weight, somewhat lethargic,
but morally sound.

Reprehensible as was masturbation among males, it was an even graver
problem among Victorian females, who were viewed as delicate, sensitive,
frail, and emotional creatures. In response to an article in a local
paper urging the medical regulation of prostitutes, the editor of the
New Orleans Medical and Surgical Journal began by pointing out that
the morality of American women was much higher than that of women in
other countries. Most prostitutes in New Orleans, he observed, were
foreigners. Having settled this point, he turned to "onanism" or masturbation,
a practice "very injudicious to the health of both males and females."
Men, he wrote, occasionally admitted to it, but the case with women
was far different.

To ask for or expect information from adult females about this practice,
he wrote, "is altogether useless and vain, although many of their diseases,
as leucorrhoea, uterine haemorrhage, falling of the womb, cancer, functional
disorders of the heart, spinal irritation, palpitation, hysteria, convulsions,
haggard features, emaciation, debility, mania--many symptoms called
nervous--un triste tableau, have been referred to masturbation as the
cause." Even if these disorders did not originate in masturbation, he
continued, "its practice would certainly aggravate them." The editorial
concluded with a quote from a French physician: "In my opinion, neither
the plague, nor war, nor smallpox, nor a crowd of similar evils have
resulted more disastrously for humanity, then the habit of masturbation:
it is the destroying element of civilized society."2

In 1866 an American medical journal discussed the work of a British
physician, Dr. Isaac Brown Baker, who claimed success in treating epilepsy
and other nervous disorders in female patients- by excising the clitoris.
After noting that the great mass of English medical opinion was strongly
opposed to Baker's ideas and had "unqualifiedly condemned" his operation,
the American editor concurred with the English medical profession, declaring
that to remove the clitoris "to allay sexual irritability is about as
unphilosophical as to remove the analogous organ of the male." (4)

While the clitoridectomy was only rarely performed in the English-speaking
nations, the subject of female masturbation continued to intrigue the
public and the medical profession. As the century drew on, more articles
on the subject began appearing in medical journals and the clitoridectomy
was revived. In 1889, Dr. Joseph Jones, a former president of the Louisiana
State Board of Health and a medical professor, stated that "hopeless
insanity" was one of the many consequences of masturbation and that
the child of a masturbator was liable to hereditary insanity.(8).

In 1894, Dr A.J. Bloch of New Orleans in an article entitled "Sexual
Perversion in the Female" referred to female masturbation as a "moral
leprosy." In one of his cases, he described how a schoolgirl of fourteen
suffering from nervousness and pallor had been cured by "liberating
the clitoris from its adhesions and by lecturing the patient on the
dangers of masturbation.( 10).

As far as can be ascertained, Dr. Bloch was one of the last American
surgeons to report taking such drastic measures. By this date medical
studies were beginning to demonstrate that masturbation caused no serious
functional disturbances and that the psychological problems involved
arose from the social attitude towards the practice rather than the
act itself. As these ideas gained medical acceptance during the next
thirty years, the subject of masturbation in normal individuals gradually
disappeared from medical journals.

BIOGRAPHICAL NOTE: John Duffy, Ph.D. is Clinical Professor Emeritus1
Tulane University School of Medicine and Professor Emeritus of History,
University of Maryland. Dr. Duffy is a medical historian with
some
9 published books and 50 articles. His newest book is The Sanitarians:
A History of American Public Health. University of Illinois Press
to be released in February 1990.

Haller, John S. and Robin M., The Physician and Sexuality
in Victorian America, Urbana, Chicago, and London, 1974, pp.195,
207-209.

Editorial: Review of European Legislation for Control of Prostitution,
New Orleans Med Surg J11:700-705, 1854-1855.